Type 1 diabetes is characterized by the destruction of the pancreatic beta cells of the islets of Langerhans, which are responsible for producing insulin (textbook). Insulin secretion decreases, as beta-cell mass decline, until the insulin available is no longer adequate enough to maintain normal blood glucose levels (medscape). It is not until after about 80-90% of the beta cells are destroyed that hyperglycemia develops and diabetes may be diagnosed (medscape). The onset of type 1 is usually abrupt and is often more easily recognizable in children than in adults, although symptoms are typically the same among children and adults (textbook). The most common signs to look for are known as the 3 P 's: polyuria (increased urination), polydipsia (increased thirst), and polyphagia (increased hunger) (textbook). Other signs include: weight loss, nocturia, blurred vision, headache, flushed skin, poor wound healing, frequent infections, irritability, short attention span, and lowered frustration tolerance (textbook). Even though diabetes can be quickly discovered based on signs and symptoms, diagnosis it is often delayed or mistaken for influenza, gastroenteritis, or appendicitis (textbook).
There are two forms of type 1 diabetes: immune-mediated diabetes mellitus...
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...effort to rid the body of the ketones (textbook). The kidney also attempt to compensate for the increased pH (textbook). Potassium is released from the cells into the bloodstream and excreted by the kidneys, which may cause an elevated potassium level and can lead to cardiac arrest (textbook). If DKA is not reversed progressive deterioration occurs, with dehydration, electrolyte imbalance, acidosis, coma, and death (textbook).
Diagnostics evaluations should be done if diabetes is suspected. Children should be considered a candidate for diabetes and have further testing if they present with one of the following: (1) have glycosuria, polyuria, and a history of weight loss or failure to gain weight; (2) have persistent glycosuria or it comes and goes; (3) display symptoms of metabolic acidosis. In any situation, if glycosuria is present, than diabetes must be suspected.
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